If you know what to watch for, you can help — and maybe save the life of — someone having a heart attack.

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Heart attacks are among the scariest of health crises. Everyone fears them — but not everyone knows the signs or what to do in the event they happen. Simply knowing how to respond to a heart attack (technically called myocardial infarction, or MI) can reduce the risk of death.

Defining Heart Attack

“A heart attack is the sudden onset of blockage of an artery in the heart, usually resulting from the formation of a blood clot,” says Kunjan Bhatt, a cardiologist at the Austin Heart Hospital in Texas.

A clot is a mass of blood cells that stick together. The most common experience we have with clotting is when a cut stops bleeding and forms a scab. Blood clots that cause heart attacks begin inside your coronary arteries, the blood vessels that supply your heart muscle with fresh, oxygenated blood. Your blood clots in an attempt to heal a break in the plaque, or fatty deposits, that may be narrowing your arteries. As a clot grows, it “results in diminished or absent blood flow to the heart muscle and, consequently, death of the muscle,” Dr. Bhatt says.

This is why even a non-fatal heart attack can damage your heart, leading it to function poorly and causing congestive heart failure or arrhythmia (irregular heartbeats).

Signs of Heart Attack

When you think of a heart attack you may picture the event the way it's dramatically portrayed on TV — someone clutching his chest and collapsing to the floor. But the signs aren't always so clear. Heart attack symptoms include:

Chest pain or discomfort — which Bhatt describes as “classically left-sided and pressure-like, that is, the feeling that an elephant is sitting on your chest.” Another term people use to describe this feeling is “squeezing.”

Pain moving down the left arm

Pain moving up to the left side of the jaw

Pain or discomfort in your back or stomach

Sweating

Nausea or throwing up

Shortness of breath

Dizziness

Fainting

Bhatt emphasizes that not all patients have these classic symptoms.

“Elderly patients, diabetics, and women may sometimes have atypical symptoms such as a sharp pain in the chest,” he says. Others complain of a feeling of indigestion. Since time is of the essence, it is better to seek medical help if you suspect a heart attack than to wait and see if your symptoms get better.

Responding to a Heart Attack

If you strongly suspect that you are having a heart attack, take these steps:

Chew aspirin. “Chew a 325-milligram tablet of aspirin,” advises Bhatt. Chewing the aspirin gets it into your system faster than just swallowing it. Aspirin helps reduce the clotting of your blood — but this does not treat the heart attack. Even if your symptoms ease up, you still should go to an emergency room.

Take nitroglycerin. If your doctor has already prescribed a nitroglycerin medication, it should be taken now. Do not take someone else’s nitro, however.

Call 911 immediately. Treatment for heart attack works best within one hour, and the clock starts ticking with the first symptoms. Since paramedics can usually begin treatment, such as doing an EKG and starting an intravenous line, you should take always take an ambulance to the hospital. Remember to tell the 911 operator exactly where you are — and then stay on the line.

If someone near you appears to be having a heart attack, in addition to giving him aspirin and his prescribed nitroglycerin and calling 911, you may also need to:

Start CPR. If a person with symptoms of a heart attack stops breathing and loses consciousness, his heart may have stopped beating. If this happens, you will not be able to feel a pulse, and CPR (cardiopulmonary resuscitation) needs to be started immediately. Shout for someone to call 911, if you haven’t already, and then:

Do hands-only CPR: Using both hands placed over one another, rapidly and evenly push up and down on the center of the person’s chest. Aim for 100 pushes a minute. Starting CPR doubles the chance that a person in cardiac arrest will survive — and recent studies show that the more compressions, or pushes, you do on the chest of someone whose heart has stopped, the greater the likelihood they will survive.

Don't worry about or do mouth-to-mouth resuscitation.

If you don’t know how to do CPR, ask for help from others around you.

CPR is so important to the survival of someone having a heart attack that it’s worth taking a class if you don't already have these skills. To find a CPR class near you, contact a local hospital, visit the American Red Cross, or search for a class at the American Heart Association Web site.

Did you know that fewer than one in three people who have a heart attack — even when there are other people around — get the help they need? With this basic information, you can make a difference in that statistic.

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